Evidence map›Paper›PMID 40841832›Full record

ArticleProstate cancer and prostatic diseases2026

Development and validation of a natural language processing system to assess quality of physician communication in prostate cancer consultations.

Renning Zheng, Nadine A Friedrich, Michael Luu, Rebecca Gale, Dmitry Khodyakov, Stephen J Freedland, Brennan Spiegel, Timothy J Daskivich

Abstract readValidation Study
In one paragraph

Article in Prostate cancer and prostatic diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Scoring Physician Risk Communication in Prostate Cancer Using Large Language Models.Pacific Symposium on Biocomputing. Pacific Symposium on Biocomputing · 2026
    Article
  2. Scoring Physician Risk Communication in Prostate Cancer Using Large Language Models.medRxiv : the preprint server for health sciences · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Renning ZhengDepartment of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.ORCID http://orcid.org/0009-0001-4286-2544
Nadine A FriedrichDepartment of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.ORCID http://orcid.org/0000-0002-6713-0614
Michael LuuDepartment of Biostatistics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Rebecca GaleCedars-Sinai Center for Outcomes Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Dmitry KhodyakovRAND Institute, Santa Monica, CA, USA.
Stephen J FreedlandDepartment of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.ORCID http://orcid.org/0000-0002-8104-6419
Brennan SpiegelCedars-Sinai Center for Outcomes Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Timothy J DaskivichDepartment of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Timothy.Daskivich@cshs.org.ORCID http://orcid.org/0000-0002-7540-3272

Funding

Training in Advanced Heart Disease ResearchT32HL116273 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI Joshua I Goldhaber, EDUARDO MARBAN · 2013 to 2026
$5.6M
A Patient-Centered Approach to Integration of Life Expectancy into Treatment Decision Making for Patients with Genitourinary MalignancyK08CA230155 · NCI · CEDARS-SINAI MEDICAL CENTER · PI DASKIVICH, TIMOTHY · 2018 to 2022
$909k
Natural Language Processing Based Consultation Feedback to Improve Patient Decision Making and Physician Risk CommunicationR01CA290559 · NCI · CEDARS-SINAI MEDICAL CENTER · PI TIMOTHY DASKIVICH · 2025 to 2026
$761k
NCI NIH HHS K08 CA230155NCI NIH HHS R01 CA290559NHLBI NIH HHS T32 HL116273U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI) nadine.friedrich@cshs.org
6 · The paper itself

Abstract

backgroundAUA guidelines for shared decision making (SDM) in prostate cancer recommend discussion of five content areas in consultations: (1) cancer severity (tumor risk (TR), pathology results (PR)); (2) life expectancy (LE); (3) cancer prognosis (CP); (4) baseline urinary and erectile function (UF and EF); and (5) treatment side effects (erectile dysfunction (ED), urinary incontinence (UI), and irritative urinary symptoms (LUTS)). However, patient retention of information after the visit and inconsistent risk communication by physicians are barriers to informed SDM. We sought to develop natural language processing (NLP) models based on recorded consultations to provide key information to patients and audit quality of physician communication.

methodsWe used 50 consultation transcripts to train and validate NLP models to identify sentences related to key concepts. We then tested whether communication quality across entire consultations could be determined by sentences with the highest model-predicted topic concordance in 20 separate consultation transcripts.

resultsOur development dataset included 28,927 total sentences, with 75% reserved for training and 25% for internal validation. The Random Forest model had the highest accuracy for identifying topic-concordant sentences, with area under the curve 0.98, 0.94, 0.89, 0.92, 0.84, 0.96, 0.98, 0.97, and 0.99 for TR, PR, LE, CP, UF, EF, ED, UI, and LUTS compared with manual coding across all concepts in the internal validation dataset. In 20 separate consultations, the top 10 model-identified sentences correctly graded communication quality across entire consultations with accuracies of 100%, 90%, 95%, 95%, 80%, 95%, 85%, 100%, and 95% for TR, PR, LE, CP, UF, EF, ED, UI, and LUTS compared with manual coding, respectively.

conclusionsNLP models accurately capture key information and grade quality of physician communication in prostate cancer consultations, providing the foundation for scalable quality assessment of risk communication.

Indexed as

CommunicationNatural Language ProcessingPhysician-Patient RelationsPhysiciansProstatic NeoplasmsReferral and ConsultationDecision Making, SharedHumansMaleMiddle AgedPrognosis

Identifiers

PMID40841832
PMCPMC12707102

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.